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针刺与口服药物治疗急性/亚急性非特异性下腰痛:系统评价和荟萃分析。

Acupuncture Versus Oral Medications for Acute/Subacute Non-Specific Low Back Pain: A Systematic Review and Meta-Analysis.

机构信息

Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.

Department of Acupuncture-Moxibustion, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100053, China.

出版信息

Curr Pain Headache Rep. 2024 Jun;28(6):489-500. doi: 10.1007/s11916-023-01201-7. Epub 2024 Jan 8.

Abstract

PURPOSE OF REVIEW

Pharmacologic intervention do not always achieve benefits in the treatment of acute/subacute non-specific low back pain (NSLBP). We assessed efficacy and safety of acupuncture for acute/subacute NSLBP as alternative treatment.

RECENT FINDINGS

We searched PubMed, Web of Science, Embase, Cochrane Library, Scopus, Epistemonikos, CNKI, Wan Fang Database, VIP database, CBMLD, CSTJ, clinical trials, EUCTR, World WHO ICTRP, and ChiCTR for randomized controlled trials, cross-over studies, and cohort studies of NSLBP treated by acupuncture versus oral medication from inception to 23th April 2022. A total of 6 784 records were identified, and 14 studies were included 1 263 participants in this review. The results of the meta-analysis indicated that acupuncture therapy was slightly more effective than oral medication in improving pain (P < 0.00001, I = 92%, MD = -1.17, 95% CI [-1.61, -0.72]). According to the results of the meta-analysis, acupuncture therapy exhibited a significant advantage over oral medication with a substantial effect (P < 0.00001, I = 90%, SMD = -1.42, 95% CI [-2.22, -0.62]). Based on the results of the meta-analysis, acupuncture therapy was associated with a 12% improvement rate compared to oral medication in patients with acute/subacute NSLBP (P < 0.0001, I = 54%, RR = 1.11, 95% CI [1.05, 1.18]). Acupuncture is more effective and safer than oral medication in treating acute/subacute NSLBP. This systematic review is poised to offer valuable guidance to clinicians treating acute/subacute NSLBP and potentially benefit the afflicted patients.

REGISTRATION

This review was registered in PROSPERO ( http://www.crd.york.ac.uk/prospero ) with registration number CRD42021278346.

摘要

目的综述

药物干预在治疗急性/亚急性非特异性下背痛(NSLBP)中并不总能带来益处。我们评估了针灸治疗急性/亚急性 NSLBP 的疗效和安全性,作为替代治疗方法。

最近的发现

我们检索了 PubMed、Web of Science、Embase、Cochrane 图书馆、Scopus、Epistemonikos、CNKI、万方数据库、维普数据库、中国生物医学文献数据库、中国临床试验注册中心、欧盟临床试验注册平台、世界卫生组织国际临床试验注册平台和 ChiCTR,以获取从成立到 2022 年 4 月 23 日针灸治疗 NSLBP 的随机对照试验、交叉研究和队列研究的文献。共确定了 6784 条记录,本综述纳入了 14 项研究,共 1263 名参与者。荟萃分析结果表明,针灸治疗在改善疼痛方面略优于口服药物(P<0.00001,I=92%,MD=-1.17,95%CI[-1.61,-0.72])。根据荟萃分析结果,针灸疗法在疗效上明显优于口服药物(P<0.00001,I=90%,SMD=-1.42,95%CI[-2.22,-0.62])。根据荟萃分析结果,与口服药物相比,针灸治疗在急性/亚急性 NSLBP 患者中具有 12%的改善率(P<0.0001,I=54%,RR=1.11,95%CI[1.05,1.18])。针灸治疗急性/亚急性 NSLBP 的疗效优于口服药物,且安全性更高。本系统综述为治疗急性/亚急性 NSLBP 的临床医生提供了有价值的指导,并可能使受影响的患者受益。

注册

本综述在 PROSPERO(http://www.crd.york.ac.uk/prospero)进行了注册,注册号为 CRD42021278346。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8181/11156714/ef8855ba2b26/11916_2023_1201_Fig1_HTML.jpg

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